In the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2010; 107[31-32]: 543-51), Stephanie Holt, a clinical pharmacologist, and coauthors present the PRISCUS List: a list of medications that carry an increased risk of side effects when given to elderly patients.
The authors present the new list, which was developed specifically for Germany in the setting of a joint project entitled PRISCUS (Latin for “old and venerable”), and discuss its potential applications. Most patients take more medications as they grow older and thus run a greater risk of drug interactions and side effects. Medications that might cause side effects more frequently in elderly patients than they do in the overall population are called potentially inappropriate medications (PIM). A number of PIM lists already exist for countries other than Germany; these cannot be applied directly to the German situation because of differences between countries with respect to drug approval, prescribing practices, and treatment guidelines. The experts who created the PRISCUS list for Germany, proceeding on the basis of a literature search and a qualitative analysis of existing PIM lists from other countries, judged 83 medications to be potentially inappropriate for elderly patients. The authors of the article call the PRISCUS list an important aid in medical decision-making. The full list can be seen at www.priscus.net (in German).